Health, Medicine, and the Study of Africa

by

Kalala Ngalamulume

• LAST REVIEWED: 17 August 2023
• LAST MODIFIED: 26 April 2018
• DOI: 10.1093/obo/9780199846733-0050

Introduction

Disease has played an important role in human history. It has determined the fate of armies, weakened and precipitated the fall of political communities, and caused tremendous human suffering. In Africa in particular, biological interactions among pathogens, vectors, and hosts (humans and other vertebrates) have produced an uneven disease environment characterized by a disease balance in some areas and disease endemicity in others. The evidence suggests that hunting and gathering societies had few epidemic diseases because of their small sizes and their mobility, and that agricultural societies experienced endemic contagious diseases as a result of interaction with domestic as well as wild animals. In the process of mastering their continent, Africans developed healing traditions that were holistic, dynamic, and open to cross-cultural exchanges and continual change. The period of the slave trade witnessed an increase in the frequency of contagious diseases, such as yaw and smallpox, as well as the introduction of new diseases, chief among them yellow fever and syphilis. The increasing disease threats gave impetus to regional and trans-regional healing cults that spread over vast areas, such as Lemba and Ngoma in Central Africa. Although colonial conquest, rule, and exploitation contributed to the burden of disease, Western medicine and public health measures helped reduce mortality and achieve population growth, especially in urban centers. After independence, rapid urban growth, combined with poor medical infrastructure and deficient garbage collection, made cities microbe magnets.

General Overviews

Health in Africa is determined by various environmental, social, economic, political, cultural, religious, and ideological as well as external factors. Feierman 1985 provides a review of the existing literature on health and healing in Africa. Feierman and Janzen 1992 is a comprehensive discussion of the social context of disease in Africa, including the development of local therapeutic traditions and the broad political and economic forces that negatively affect health and disease, such as colonialism and particular forms of production. Prins 1989 reviews the negative images of Africa as a diseased continent and attempts to reconstruct the disease ecology of and colonial conquest in Africa, building on John Ford’s work on trypanosomiasis. Schumaker, et al. 2007 is a review of the literature on African healing in southern Africa.

• Feierman, Steven. “Struggles for Control: The Social Roots of Health and Healing in Modern Africa.” African Historical Review 28.2–3 (1985): 73–147.

  The article reviews the literature on the social organization of therapy, the social context of health and disease, and the role played by healers or physicians in therapeutic decisions in modern Africa until the early 1980s. Available online for purchase or by subscription.

• Feierman, Steven, and John M. Janzen, eds. The Social Basis of Health and Healing in Africa. Berkeley: University of California Press, 1992.

  Contributions include an analysis of the factors that contributed to health and disease during the colonial period, such as socioeconomic changes, commercial crops, industrialization, and their health consequences (famine, smallpox, tuberculosis, etc.); an overview of therapeutic traditions of Africa in historical perspective (precolonial medicine, colonial medicine, and 20th-century medicine); and postcolonial medicine.

• Prins, Gwyn. “But What Was the Disease? The Present State of Health and Healing in African Studies.” Past & Present 124 (1989): 159–179.

  DOI: 10.1093/past/124.1.159

  Discusses the genealogy of negative images of the disease environment of Africa and engages in the reconstruction of the disease ecology during the period of colonial conquest. Available online for purchase or by subscription.

• Schumaker, Lyn, Diana Jeater, and Tracy Luedke. “Introduction: Histories of Healing: Past and Present Medical Practices in Africa and the Diaspora.” Journal of Southern African Studies 33.4 (2007): 707–714.

  DOI: 10.1080/03057070701646761

  An overview of the interdisciplinary literature on African healing and its transformation in the societies of southern Africa and in the diasporas of healers from Africa to the Caribbean and from South Asia to Africa. Available online for purchase or by subscription.